CERTIFICATE OF ELIGIBILITY

SAINT CATHERINE LABOURE PARISH

Shrine of the Miraculous Medal
CERTIFICATE OF ELIGIBILITY
FOR A PARISHIONER TO SERVE AS A SPONSOR FOR THE SACRAMENT OF (check one)*

BAPTISMCONFIRMATION
Your (Sponsor's) Full Name*
Parish Where you are a registered member (if you are not a parishioner of St. Catherine Labouré parish, after you hit 'submit', please print and take the completed form to your own parish for your Pastor's signature)*
Candidate's Name (the name of the person whom you are sponsoring)*
Church where Candidate will be Baptized/Confirmed*
STATEMENT OF SPONSOR

I accept the responsibility of being a model of a committed, active Catholic and to be a support to the parents of the person whom I am sponsoring in the practice of our mutual Christian faith.
I give my assurance that (check the applicable boxes below):

I am at least 16 years oldI have been Baptized in the Catholic Church (or have been received into her by profession of faith) and I have received the Sacrament of Confirmation in the Catholic (or Orthodox) ChurchI am in Communion with the Catholic Church i.e., I haven't joined another church or religion
My marital state is (check one)

SingleCohabitating (living with significant other without being married)Civilly MarriedMarried in another non-Catholic church (without dispensation from canonical form)Married in the Catholic Church or in another church/location with dispensation from canonical form
Place of marriage (Name & Address of Church)
Date of marriage

MonthDayYear
Date
I am fulfilling my fundamental obligations as a Catholic by (check all that apply):

participating in Sunday Mass weeklyreceiving the Holy Eucharist and Penance regularlybeing open to the Word of God as revealed in Scripture and the teachings of the Catholic Churchwitnessing to the values of the Gospel of Jesus Christ by seeking to be of service to others for love of Him.
Frequency of your attendance at Mass:*
Your Telephone Number*
Format: (000) 000-0000.
Your email address
example@example.com
Promise of the Sponsor

I promise to give my full support to the person I am sponsoring by my prayers and the Christian example of my daily life.
Date

MonthDayYear
Date
Should be Empty:

SAINT CATHERINE LABOURE PARISH

CERTIFICATE OF ELIGIBILITY